which sugar is causing my upset stomach?

Lactose or sucrose?

Have you ever eaten a meal and 20 to 30 minutes later you had that rumble in your stomach and thought you had better find a bathroom quick? Do you wake up in the morning with a nice flat belly, but by 6 p.m. look six months pregnant? Have you tried every diet out there and nothing seems to help? Have any of these issues been going on for as long as you can remember? Have you ever considered sugar as the reason you are having these symptoms? Well, we may be able to shed some light on the reasons behind these symptoms.

Sucrose Intolerance, also known as Congenital Sucrase Isomaltase Deficiency (CSID), is a rare, genetic disease that is characterized by the symptoms mentioned above. Sucrose is table sugar. It is a disaccharide, which means it is made up of two smaller sugars, glucose and fructose. Sucrose must be separated into these smaller sugars to be absorbed in the intestine.

In the small intestine, an enzyme called sucrase acts on the sucrose in foods to separate glucose from fructose. If you have a functioning sucrase enzyme, you can eat sugar with no adverse side effects. If you are deficient in sucrase, the sugar is not separated and winds up in the large intestine where bacteria feed on it, causing those yucky symptoms.

Most of you have heard of lactose intolerance and know that the symptoms of gas and diarrhea following a meal or snack with milk or cheese are an indication of the intolerance. This condition is caused by a deficiency in lactase, which breaks milk sugar into smaller sugars for absorption. Lactose intolerance is fairly common and happens to many people as they get older.

When you have symptoms of gas, bloating, diarrhea, and cramping after meals and explain your symptoms to your doctor, one common reaction is a preliminary diagnosis of lactose intolerance. For many, this diagnosis may be correct. With the help of over-the-counter lactase or lactose-free products, they can eat ice cream or queso without any symptoms. However, for some of you, lactose isn’t the only problem, and CSID should be considered.

How can you find out if sucrose is really your problem? The “gold standard” for assessing sucrase function is a biopsy from the small intestine, an invasive procedure performed by a gastroenterologist. But you can also use breath testing to help identify a sucrase deficiency.

There are two types of breath tests that can provide information to your doctor that can help determine if you have CSID. These can be performed in the comfort of your own home: the sucrose hydrogen breath test and the 13C sucrose breath test. These tests consist of drinking a sugar-water solution and blowing into a series of test tubes for analysis. However, taking these tests might cause severe symptoms if you are sensitive to sugar. A gastroenterologist will be familiar with both tests. If you do suspect that sugar is causing you issues, you might want to talk to your doctor about testing you.

Sugar is present in many of the foods you eat. And it’s not just the sugar in processed foods like ice cream or cake, but also the sugar in vegetables and fruits like carrots and oranges. Because sucrose is in so many foods, eliminating it entirely would be quite difficult. Combined with some diet modifications and therapy, the symptoms of CSID can be reduced significantly, allowing for a healthy diet that even may include some dessert.

Do you think you might have CSID? Take the quiz at www.sucroseintolerance.com to give you insight as to whether you should talk to your doctor about being tested for CSID.